Stapling is known in the surgical arts as an alternative to suturing as a method of mechanically fastening cut or torn human tissue as an aid in the healing process. Stapling, or the use of independent rigid or semi-rigid multiple prong penetrating fasteners, enjoys several broad advantages relative to suturing. While suturing in effect results in a customized wound closure, stapling is faster and eliminates tasks requiring direct manipulation of tissue by a doctor or technician. The latter feature is paramount in cases where such manipulation is impractical or impossible, such as in endoscopy or laparoscopy or other minimally invasive surgical techniques. Such techniques characteristically require manipulation and repair of bodily tissues which cannot be directly seen or touched by a physician. Suturing has not proven practicable under these conditions using existing technology. Hence there is a continuing demand for improved methods of fastening for use in minimally invasive surgical techniques, and in particular, improved and various methods of stapling.
In minimally invasive surgery, operating space is at a premium, and in particular, dimensional extension in directions transverse to a longitudinal axis of a laparoscopic or endoscopic device is severely limited. Devices employed in the corresponding surgical tasks, such as endoscopes and laparoscopes generally have one elongate and two limited transverse dimensions: the resulting operational problem is analogous to constructing a model ship through the narrow neck of a bottle. Existing solutions to the problem of delivering a staple through a narrow channel in an endoscopic or laparoscipic procedure include fasteners or clamps which are biased closed, fed to an operating site in a closed configuration and forced open by a stapling tool at a point of use. Upon release by the tool, the fastener clamps intervening tissue. Another solution is to feed a fastener in a distorted closed configuration to the operating site, allow the fastener to open under internal spring forces just prior to application, and force the fastener closed a second time in an undistorted closed configuration, permitting engagement of locking elements to maintain the fastener in a closed configuration.
While endoscopic fastening devices certainly exist, the field is not mature, and a novel fastening assembly employing a parameter set or design choices not universally inferior in result to existing sets of parameters of design choices has a positive probability of proving superior to existing devices in solving some particular surgical problem. In particular, a novel surgical fastening device or assembly, allowing, relative to prior art, either a greater variety of fastener types to be inserted into a patient's body, or insertion at novel orientations relative to a distal tip of a minimally invasive surgical device, has a prima facie utility in the minimally invasive surgical arts.